|
KMID : 0358819870140020177
|
|
Journal of Korean Society of Plastic and Reconstructive Surgeons
1987 Volume.14 No. 2 p.177 ~ p.183
|
|
|
EXPERIMENTAL STUDY OF IMPROVEMENT IN ANASTOMOTIC PATENCY BY APPLICATION OF LIDOCAINE AND CHLORPROMAZINE
|
|
Kim Young-Seo
Kim Ing-Gon
Lew Jai-Mann
|
|
|
Abstract
|
|
|
Recalcitrant vasospasm remains an occasional and difficult problem in microvascular surgery. The resultant hypoperfusion has been thought to contribute to ultimate failure of free-tissus transfers. We studied to relieve the vasospasm by application of 20% lidocaine and chlorpromazine to be known as a vasodilating agent.
Sixty Sprague-Dawley rats weigning 250 to 350 gm. were randomly distributed into six groups of 10 rats each. Carotid artery was exposed, and the adventitia of the vessel was stripped to allow maximum effect of topical agents. Group 1 (anastomosis only) estabilished a carotid anastomotic patency rate for the surgeon. Group 2 (epinephrine induced vasospasm) measured the degree of reduction in patency by application of epinephrine. Group 3 (epinephrine and 20% lidocaine) and Group 4 (epinephrine and chlorpromazine) evaluated improvement in the patency rate of Group 2 by topical application of either 20% lidocaine or chlorpromazine. Group 5 (20% lidocaine only) and Group 6 (chlorpromazine only) were observed the effect of either 20% lidocine or chlorpromazine without prior application of epinephrine. Patency rate was recorded at 7th day of post-operation.
The result was as follows;
1. In group 1, 8 of 10 vessels were patent at 7th post-operative day.(80% anastomotic patency ate)
2. In group 2, 4 of 10 vessels were patent for a 40% patency rate.
3. In group 3 and 4, 70% and 80% patency rates were noted each.
4. In group 5 and 6, 90% and 100% patency rates were recorded each.
Lidocaine was known to affect ion flux in both nerve and smooth-muscle cell membranes. Chlorpromazine had been shown to inhibit formation of the calcium-calmoduline complex and thus inhibit contration of the cell. We found that epinephrine-induced vasospasm was to significantly impair anastomotic patency. Both 20% lidocaine and chloopromazine were shown to relieve vasospasm. Chlorpromazine was shown to improve the patency rate of vessels in this study, and it was found to be superior to 20% lidocaine in improving anasotmotic patency.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|